Table 3 Attributes and Indicators Used for the Assessment of Quality of Care in This Study
| Â | Definition of indicators |
|---|---|
STRUCTURE | Â |
Infrastructure & equipment | Â |
Physical infrastructure | Number of amenities available at facility: electricity, water, working toilet, telephone, waiting area for clients (out of 5) |
Examination room equipment | Number of following items present: table and stool for gynecological exam, source of light, speculum, soap, single-use towel, water for hand-washing, clean gloves, decontamination solution, sharps box, privacy in exam room (out of 10) |
Management | Â |
Review of management | Whether there is a system for reviewing management/administrative issues |
System to collect client opinion | Whether there is a system to obtain clients' opinions regarding services |
Quality assurance program | Whether the facility has a routine program for quality monitoring |
Supervision | Whether the last supervisory visit to the facility was in the last 6 months |
Stock inventory, organization, and quality | Number of following items present at facility: inventory for contraceptive supplies, stock organized by expiry date, contraceptives protected from water, sun, and pests |
Availability of services | Â |
Number of days services provided | Number of days per week that FP services are provided |
Availability of provider | Whether a trained provider is always available at the facility |
FP methods offered | Number of methods offered: combined oral pill, progesterone only pill, IUD, 2 or 3 month injectable, 1 month injectable, Norplant, male condom, female condom, spermicide, diaphragm, emergency contraception, counseling about natural methods, tubectomy, vasectory (out of 14) |
Other reproductive health services offered | Number of RH services besides FP offered: STI services, immunization, antenatal care, postnatal care, postabortion care, and delivery (out of 6) |
Counseling | Â |
Guidelines | Number of guidelines or protocols for counseling at the facility (out of 5) |
Visual aids | Number of visual aids for demonstrating use of FP methods at facility (out of 9) |
Privacy | Whether facility has private room for FP counseling |
Individual client card | Whether there is an individual client card/record for FP |
FP experience of providers | Number of years of experience of providers in providing FP services |
Providers trained in FP | Number of providers who received any in-service training in FP in last 5 years |
PROCESS | Â |
Interpersonal | Â |
Waiting time | Number of minutes client had to wait before being examined by a provider |
Privacy ensured | Whether provider ensured visual and auditory privacy during examination |
Client concerns noted | Whether provider asked client about concerns with methods or with currently used method |
Confidentiality assured | Whether provider assured client of confidentiality |
Method use explained | Whether provider explained to the client how to use the method |
Injectable prescription | Whether provider prescribed an injectable to the client |
Technical | Â |
Reproductive history | Provider asked the client about the following: age, number of living children, last delivery date, history of complications, pregnancy status, desire for more children, desired timing of birth of next child, breastfeeding status, regularity of menstrual cycle (out of 9) |
Physical examination | Provider took/asked about the following during the physical exam: blood pressure, weight, asked about smoking, asked about STI symptoms, asked about chronic illness (out of 5) |
Injectable procedure | Provider did the following when giving FP injection: checked client card, wash hands with soap before giving injection, use single-use towel for drying, use newly sterilized needle, stir bottle before drawing dose, clean and air-dry injection site before injection, draw back plunger before injection, allow dose to self-disperse instead of massaging, dispose of needle in puncture resistant container (out of 9) |
Duration of consultation | Number of minutes provider spent on the consultation |
OUTCOME | Â |
Client satisfaction | Clients reported that they had no problem with ALL of the following: waiting time, ability to discuss concerns with provider, amount of explanation given, quality of examination and treatment provided, visual privacy during examination, auditory privacy during examination, availability of medicines at facility, hours of service provision, cleanliness of facility, staff treatment of client |